P3972 Greenwood LakesDAVIE COUNTY HEALTH DEPARTMENT
SEPTIC TANK PERMIT
Date 5
Jxmer/Occupant •f l'JnI ez
To:
Address ��r�QK�€oadL,lQKeSe % % /�oHe�
Address
Building Contractor &141_tk
Address
Cal. Manufacturer's Name — _Z (,�,7 %�2k-:,,�Address Zj
No. of lines _n2_ Width 3 kin. Total
length ft.
No. sq.
ft.
Type of filter material
Total tons used
5-0
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line
400
Two-bedroom house
800
600
Three-bedroom house
900
900
No one shall install a septic tank in Davie County without a permit from the Health Offic
or his agent.
Date of Final Approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installedccording to spe ifricatioz
Signed.
Sep—tic—Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
81"D /